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The purpose of the Active By Community Design (ABCD) project was to engage residents in the redesign of two public open spaces to increase park visits and park-based physical activity (PBPA). It was anticipated that by adding local preferences to park design considerations along with collected data and available evidence, the study would achieve increased levels of community engagement and subsequent increases in park visits and PBPA. This study summarizes two case studies outlining the community engagement and research translation process. Utilizing a pre–post evaluation design, baseline measures were completed with a series of validated tools for park use and park quality. Baseline data, evidence, community and stakeholder input were synthesized and presented to a "design subcommittee" to translate into "real-world" park redesigns. Park audits, a household survey, and park open days identified the spaces were not designed for the activities residents wanted, while park observations identified usage was low, and those observed were mostly children and adults walking. Park redesigns focused on maximizing access, infrastructure to enable physical activity (PA), PA programs and enhancements to improve aesthetics and safety concerns. The ABCD project successfully demonstrated a process of combining data and community and stakeholder engagement input to translate evidence into the creation of more supportive environments for PA. Stakeholder and resident input to the redesign processes contributed to satisfaction and ownership that residents reported on the redesigned parks, which may increase the likelihood of increased park usage and park-based physical activity. [ABSTRACT FROM AUTHOR]

Urolithiasis composed of pyrophosphate salts has only been reported in animals, in the form of potassium magnesium pyrophosphate. However, there have been no reports of pyrophosphate stones in humans. Hypophosphatasia is an inherited disease characterized by low alkaline phosphatase activity and elevated levels of pyrophosphate in blood and urine. Urolithiasis is a part of the hypophosphatasia phenotype. The role of elevated urine pyrophosphate levels in the formation of stones in hypophosphatasia is unknown. Here, we report a case of a 60-year-old man with recurrent urolithiasis. The patient's most recent presentation was gross hematuria and his computed tomography scan showed bilateral kidney stones. Stones were removed via retrograde intrarenal surgery. Stone analysis revealed a composition of potassium magnesium pyrophosphate. The patient also has a long history of fracturing bone disease which led to the consideration of hypophosphatasia as the cause of both his bone disease and pyrophosphate stones. Hypophosphatasia was confirmed by genetic analysis. Pyrophosphate has been of interest in the fields of mineral metabolism because of its action as a crystallization inhibitor. However, pyrophosphate at elevated concentrations in the presence of divalent cations can exceed its solubility. Nephrocalcinosis and stone disease have been described in hypophosphatasia; stones have been assumed to be calcium phosphate but no compositional analysis has been reported. This is the first report of human stones composed of pyrophosphate salts, which led to the subsequent diagnosis of hypophosphatasia in this patient. [ABSTRACT FROM AUTHOR]

Although there has been an increase in the availability of effective, evidence-based physical activity interventions in school settings during the past decade, there is a paucity of published research focusing on the translation of these effective interventions into real-world practice. The purpose of this research was to examine the translatability of an existing school-based physical activity intervention. More specifically, this research sought to identify the barriers and facilitators in adopting, implementing, and maintaining a school-based physical activity intervention using RE-AIM as a theoretical evaluation framework. It was concluded that interventions that consider issues around complexity and compatibility with the school setting are more likely to be adopted, implemented, and maintained. It was recommended that future evaluations of physical activity interventions should not be limited to testing internal validity, but should consider external validity and ecological aspects, relevant to increasing dissemination in real-world settings. [ABSTRACT FROM AUTHOR]

Proposes a health care financing system for health insurance in the U.S. Identification of the health insurance-related problems in the country which require solutions; Analysis of the solutions offered by the proposed health financing system; Discussion on the other advantages offered by the proposed health financing system.

Offers a study on the effects of methylphenidate on children with attention deficit hyperactivity disorder (ADHD). Materials and methodology; Result; Discussion on the results.

A pediatric assistant performs health screening examinations in a private pediatric practice without the presence of the doctor. Only patients between the ages of 6 to 12 years who have no apparent significant problems and who have had a complete physical and history by a pediatrician the year previously are accepted for the screening, which includes a system review, height, weight, visual and hearing testing, hemoglobin, urinalysis, and immunizations. The pediatric assistant, chosen for her ability to communicate with mothers, is of special value in listening to minor complaints. The chart is reviewed by the child's pediatrician and problems are discussed with the assistant. Physician follow-up is accomplished if deemed helpful. This is accepted by patients, allows continuity of personal comprehensive medical care in the pediatric orifice at a reduced cost, and allows the physician more time for patient care while increasing efficient use of paramedical personnel. Possible misuse of screening examinations, with resulting impersonal and fragmented medical care, is discussed. [ABSTRACT FROM AUTHOR]

GS-441524 is an adenosine nucleoside antiviral demonstrating significant efficacy in the treatment of feline infectious peritonitis (FIP), an otherwise fatal illness, resulting from infection with feline coronavirus. However, following the emergence of COVID-19, veterinary development was halted, and Gilead pursued clinical development of a GS-441524 pro-drug, resulting in the approval of Remdesivir under an FDA emergency use authorization. Despite lack of regulatory approval, GS-441524 is available without a prescription through various unlicensed online distributors and is commonly purchased by pet owners for the treatment of FIP. Herein, we report data obtained from the analytical characterization of two feline renal calculi, demonstrating the propensity for GS-441524 to cause renal toxicity through drug-induced crystal nephropathy in vivo. As definitive diagnosis of drug-induced crystal nephropathy requires confirmation of the lithogenic material to accurately attribute a mechanism of toxicity, renal stone composition and crystalline matrix were characterized using ultra-performance liquid chromatography photodiode array detection (UPLC-PDA), ultra-performance liquid chromatography mass spectrometry (LCMS), nuclear magnetic resonance (NMR) spectroscopy, X-ray powder diffraction (XRD), and Fourier-transform infrared spectroscopy (FTIR). This work serves to provide the first analytical confirmation of GS-441524-induced crystal nephropathy in an effort to support toxicologic identification of adverse renal effects caused by administration of GS-441524 or any pro-drug thereof. [Display omitted] • This work describes the first analytical confirmation of GS-441524 toxicity in vivo. • Samples were obtained from felines with suspected GS-441524 crystal nephropathy. • Renal stones were characterized by UPLC-PDA, LCMS, NMR, XRD, and FTIR. • Consistent spectral results were observed across all analytical techniques. [ABSTRACT FROM AUTHOR]

Comments on the focus of the American Academy of Pediatrics. Campaign of the academy to promote pediatrics and pediatricians; Benefits of the increase in the number of pediatricians; Concept of continuous, comprehensive personal care developed by most pediatricians.

Issue Addressed: Colorectal cancer (CRC) screening through fecal occult blood testing (FOBT) has saved thousands of lives globally with multiple countries adopting comprehensive population wide screening programs. Participation rates in FOBT based CRC screening for the socially and economically disadvantaged remains low. The aim of this systematic review is to explore empirical evidence that will guide targeted interventions to improve participation rates within priority populations. Methods: PubMed, Embase, Scopus, Cinahl and PsycInfo were systematically searched from inception to 22 June 2022. Eligible studies contained qualitative evidence identifying barriers to FOBT based CRC screening for populations impacted by the social determinants of health. An inductive thematic synthesis approach was applied using grounded theory methodology, to explore descriptive themes and interpret these into higher order analytical constructs and theories. Results: A total of 8,501 publications were identified and screened. A total of 48 studies from 10 countries were eligible for inclusion, representing 2,232 subjects. Coding within included studies resulted in 30 key descriptive themes with a thematic frequency greater than 10%. Coded themes applied to four overarching, interconnected barriers driving inequality for priority populations: social, behavioural, economic and technical/interfaces. So What?: This study has highlighted the need for stronger patient/provider relationships to mitigate barriers to FOBT screening participation for diverse groups. Findings can assist health professionals and policy makers address the systemic exclusion of priority populations in cancer screening by moving beyond the responsibility of the individual to a focus on addressing the information asymmetry driving low value perceptions. [ABSTRACT FROM AUTHOR]

Feline infectious peritonitis (FIP) historically has been a fatal disease in cats. Recent unlicensed use of antiviral medication has been shown to markedly improve survival of this infection. An 8‐month‐old female spayed domestic short‐haired cat undergoing treatment for presumptive FIP with the antiviral nucleoside analog GS‐441524 developed acute progressive azotemia. Abdominal ultrasound examination identified multifocal urolithiasis including renal, ureteral, and cystic calculi. Unilateral ureteral obstruction progressed to suspected bilateral ureteral obstruction and subcutaneous ureteral bypass (SUB) was performed along with urolith removal and submission for analysis. A 2‐year‐old male neutered domestic medium‐haired cat undergoing treatment for confirmed FIP with GS‐441524 developed dysuria (weak urine stream, urinary incontinence, and difficulty expressing the urinary bladder). This cat also was diagnosed sonographically with multifocal urolithiasis requiring temporary tube cystostomy after cystotomy and urolith removal. In both cases, initial urolith analysis showed unidentified material. Additional testing confirmed the calculi in both cats to be 98% consistent with GS‐441524. Additional clinical studies are required to determine best screening practices for cats presented for urolithiasis during treatment with GS‐441524. [ABSTRACT FROM AUTHOR]

Background: Over 70% of cervical cancers are detected in women not currently screening. Queensland Health wanted to better understand the drivers of screening to inform our planning and capitalise on self‐collection as an option to reach under‐screened women. In 2020 Queensland Health commissioned qualitative research to explore barriers and enablers to cervical screening with never‐screened and under‐screened women in Queensland (with under‐screeners defined as having last screened more than 4 years ago and being more than 2 years overdue). Additionally, the research explored the acceptability of self‐collection amongst this cohort. Methods: A mixed methods qualitative approach of online focus groups and in‐depth interviews was employed. Online focus groups were conducted with under‐screeners. In‐depth telephone interviews were conducted with never‐screeners due to the anticipated personal nature of their reasons for not screening. Results: A total of 51 Queensland women aged 30 to 50 years participated in the research. Conclusions: Queensland women cited several negative experiences and aspects of the current program, as well as barriers in their social and personal lives that limited screening intention and behaviour. Barriers and enablers to cervical screening identified in this research have been classified into four categories: structural, knowledge and attitudinal, social, and personal. The research identified more factors associated with nonparticipation than participation. However, the research did uncover a range of potential enablers to encourage screening, some of which related to the program design. So What?: The concept of self‐collection was broadly well accepted by research participants, particularly by never‐screeners. Recommendations resulting from this research include communications, systems, and eligibility changes, particularly regarding the availability and benefits of self‐collection. [ABSTRACT FROM AUTHOR]

Comments on the notion of well-child care and the reaction of U.S. pediatricians to it. Issues involved in the notion of well-child care; Reaction of the health insurance to the practice of well-child care by pediatricians; Necessity of creating a single authoritative source of standards for well-child care.

Reports on the elections held by members of the North Texas chapter of the American Meteorological Society on May 14, 1996. Elected officers.

Presents information on the child health care financing. Standards for comprehensiveness and quality assurance; Standards for cost-containment.

Abstract: Purpose: The objective of this study is to evaluate acceptability of the PATH Woman''s Condom among user populations in Mexico, South Africa and Thailand. Methods: A nonrandomized, nonblinded, nonsignificant risk study was conducted among 20 couples per site. Data were collected via structured questionnaires after the first, second and third condom uses and through in-depth interviews after all condoms were used. Results: Women from all sites reported that the PATH Woman''s Condom was easy and comfortable to insert, and the pouch and ring were very stable during use. Both women and men reported that the comfort and sensation of sex while using the condom was acceptable. Conclusions: The PATH Woman''s Condom is easy to use, stable during use, comfortable and satisfactory during sex among users from diverse populations and cultures. The iterative user-driven product development process helped ensure that this new product addresses a wide range of user preferences. [Copyright &y& Elsevier]

Background: Continuous oxygen treatment is essential for managing children with hypoxemia, but access to oxygen in low-resource countries remains problematic. Given the high burden of pneumonia in these countries and the fact that flow can be gradually reduced as therapy progresses, oxygen conservation through routine titration warrants exploration. Aim: To determine the amount of oxygen saved via titration during oxygen therapy for children with hypoxemic pneumonia. Methods: Based on published clinical data, we developed a model of oxygen flow rates needed to manage hypoxemia, assuming recommended flow rate at start of therapy, and comparing total oxygen used with routine titration every 3 minutes or once every 24 hours versus no titration. Results: Titration every 3 minutes or every 24 hours provided oxygen savings estimated at 11.7% ± 5.1% and 8.1% ± 5.1% (average ± standard error of the mean, n = 3), respectively. For every 100 patients, 44 or 30 kiloliters would be saved—equivalent to 733 or 500 hours at 1 liter per minute. Conclusions: Ongoing titration can conserve oxygen, even performed once-daily. While clinical validation is necessary, these findings could provide incentive for the routine use of pulse oximeters for patient management, as well as further development of automated systems. [ABSTRACT FROM AUTHOR]

Hypoxemia is a complication of pneumonia—the leading infectious cause of death in children worldwide. Treatment generally requires oxygen-enriched air, but access in low-resource settings is expensive and unreliable. We explored use of reservoir cannulas (RCs), which yield oxygen savings in adults but have not been examined in children. Toddler, small child, and adolescent breathing profiles were simulated with artificial lung and airway models. An oxygen concentrator provided flow rates of 0 to 5 L/min via a standard nasal cannula (NC) or RC, and delivered oxygen fraction (FdO2) was measured. The oxygen savings ratio (SR) and absolute flow savings (AFS) were calculated, comparing NC and RC. We demonstrated proof-of-concept that pendant RCs could conserve oxygen during pediatric therapy. SR mean and standard deviation were 1.1±0.2 to 1.4±0.4, 1.1±0.1 to 1.7±0.3, and 1.3±0.1 to 2.4±0.3 for toddler, small child, and adolescent models, respectively. Maximum AFS observed were 0.3±0.3, 0.2±0.1, and 1.4±0.3 L/min for the same models. RCs have the potential to reduce oxygen consumption during treatment of hypoxemia in children; however, further evaluation of products is needed, followed by clinical analysis in patients. [ABSTRACT FROM AUTHOR]

Abstract: Background: We performed a pilot study to evaluate in vivo the fit of the new SILCS diaphragm, a single-size cervical barrier, using magnetic resonance imaging (MRI) in a group of women varying in body mass and parity. Study Design: Two healthy premenopausal women were recruited for each of the following groups: body mass index (BMI)<25, BMI=25–30 and BMI>30. One woman in each group was nulliparous and one was multiparous. Subjects were instructed on the placement of the SILCS diaphragm. Each subject underwent three MRI scans: baseline, with the SILCS diaphragm in place and after placement of intravaginal contrast and simulated intercourse. Results: The SILCS diaphragm was easily identified on MRI. In all subjects, the diaphragm covered the cervix. The position of the diaphragm did not change after simulated intercourse. The appropriate position of the diaphragm, as assessed by the subjects and the practitioner, was corroborated by the MR images. The intravaginal contrast was not readily visible on the images, precluding assessment of the diaphragm''s barrier properties. Conclusion: MRI confirms the anatomic position of the SILCS diaphragm in vivo, among a sample of women varying in body mass and parity. [Copyright &y& Elsevier]

Abstract: Attention deficit hyperactivity disorder (ADHD) is a neuropsychiatric syndrome common in the pediatric population. It is associated with multiple nonspecific deficits on neuropsychological tests of executive function, and a beneficial response to pharmacotherapy with methylphenidate (MPH) and other psychostimulants. The Stroop Color–Word task is used empirically as an aid in diagnosis and treatment monitoring of ADHD; however, data on the sensitivity of the Stroop interference score to the effects of MPH are limited. To address this issue, we studied Stroop performance in a cohort of 18 MPH-treated prepubescent boys with ADHD and six healthy controls on and off MPH treatment conditions. MPH significantly improved performance in both groups, with the ADHD participants consistently displaying worse scores than those of controls both on and off MPH. These results suggest that though the diagnostic value of the Stroop task in ADHD remains controversial, it has heuristic value for monitoring clinical responses to MPH treatment. More research is needed to ascertain the clinical significance of our findings and to replicate this relatively small effect in a larger cohort, to determine whether MPH effects on Stroop performance are specific to ADHD symptoms or they generalize to other forms of symptomatology. [Copyright &y& Elsevier]